CARLY DETOR NP
NPI 1114303278
Nurse Practitioner in Syracuse, NY

Active since July 30, 2015PECOS EnrolledAccepts Medicare Assignment
104 UNION AVE, SUITE 1001-1002, SYRACUSE, NY 13203(315) 423-7192(315) 423-8013 Get Directions Write a Review

NPPES record last updated: July 30, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Carly Detor Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY DETOR NP (NPI 1114303278) is an individual nurse practitioner in Syracuse, New York, licensed in New York (339796) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS, is affiliated with St Joseph's Hospital Health Center, and is a graduate of State University Of Ny Upstate Medical University (2015).

NPPES Registry Identity

NPI1114303278
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameCARLY DETORCredential: NP
Location Address104 UNION AVE, SUITE 1001-1002Syracuse, NY 13203-1843
Mailing Address104 Union Ave, Suite 1001-1002Syracuse, NY 13203-1843 · (315) 423-7192 · Fax (315) 423-8013
Fax(315) 423-8013
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2015
Enumeration DateJuly 30, 2015
NPI 1114303278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in NY · 339796
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

104 UNION AVE, Syracuse, NY 13203

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Carly Detor Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42528523
PECOS Enrollment IDI20151002000558
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
34 services34 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph's Hospital Health Center

Acute Care Hospitals · Syracuse, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330140
Location301 Prospect AvenueSyracuse, NY 13203 · Onondaga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Thoracic Surgery (Cardiothoracic Vascular Surgery)
104 UNION AVE, STE 1001-1002
SYRACUSE, NY 13203
Surgery (Vascular Surgery)
104 UNION AVE, #1005
SYRACUSE, NY 13203
Surgery (Vascular Surgery)
104 UNION AVE, #1005
SYRACUSE, NY 13203
Surgery (Vascular Surgery)
104 UNION AVE, #1005
SYRACUSE, NY 13203
Thoracic Surgery (Cardiothoracic Vascular Surgery)
104 UNION AVE, SUITE 1008
SYRACUSE, NY 13203
Nurse Practitioner (Adult Health)
104 UNION AVE, SUITE 806
SYRACUSE, NY 13203
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
104 UNION AVE, SUITE 803
SYRACUSE, NY 13203
Thoracic Surgery (Cardiothoracic Vascular Surgery)
104 UNION AVE, STE 1001-1002
SYRACUSE, NY 13203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Detor's NPI number?

The NPI number for Carly Detor is 1114303278. It was assigned to this individual provider in the NPPES registry on July 30, 2015.

Where is Carly Detor located?

Carly Detor practices at 104 Union Ave Suite 1001-1002, Syracuse, NY 13203. The listed phone number is (315) 423-7192.

What is Carly Detor's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Carly Detor enrolled in Medicare?

Yes. Carly Detor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Carly Detor affiliated with any hospitals?

According to CMS data, Carly Detor is affiliated with St Joseph's Hospital Health Center.

When was this NPI record last updated?

The NPPES record for Carly Detor was last updated on July 30, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.